医学生物PPT】医学伦理讨论会.ppt

业精于勤荒于嬉 行成于思毁于随 【医学生物PPT，欢迎收藏分享】豆丁网友,1,醫學倫理討論會 2009-02-13,PGY侯欣妤/ VS鐘焜明,业精于勤荒于嬉 行成于思毁于随 【医学生物PPT，欢迎收藏分享】豆丁网友,2,Basic data,Name:賴x彰 Gender: male Age:35 y/o Bed number: 9002B Chart Number: 21922852 Date of admission: 98/02/01,业精于勤荒于嬉 行成于思毁于随 【医学生物PPT，欢迎收藏分享】豆丁网友,3,Chief complaint,Hemoptysis for 2 days,业精于勤荒于嬉 行成于思毁于随 【医学生物PPT，欢迎收藏分享】豆丁网友,4,Present illness,35 years old male had been relatively healthy Recent 1 month, he had cough with slight yellowish sputum 2 days ago, he suffered from sudden onset of hemoptysis No fever or chills, no dizziness, no dyspnea, but mild chest pain No history of pneumonia,chronic cough, trauma, body weight loss, bleeding tendency He ever visited to 佳里綜合 hospital for treatment , and then symptoms got improved. However, recurrent hemoptysis developed at 4 PM last afternoon,业精于勤荒于嬉 行成于思毁于随 【医学生物PPT，欢迎收藏分享】豆丁网友,5,Present illness,At our ER (98.01.31 11:36pm) Vital sign: T/P/R36.6/97/22,BP: 180/124mmHg,业精于勤荒于嬉 行成于思毁于随 【医学生物PPT，欢迎收藏分享】豆丁网友,6,CXR,业精于勤荒于嬉 行成于思毁于随 【医学生物PPT，欢迎收藏分享】豆丁网友,7, Diagnosis: Hemotysis r/o bronchiectasis admitted on 98/02/01 9:31am for further evaluation and management,业精于勤荒于嬉 行成于思毁于随 【医学生物PPT，欢迎收藏分享】豆丁网友,8,Past Medical History,1. Medical history: Hypertension -(-) Diabetes mellitus -(-) Chronic hepatitis B-(-) Chronic hepatitis C-(-) 2. Surgical history: nil 3. Drug allergy: No known allergy,业精于勤荒于嬉 行成于思毁于随 【医学生物PPT，欢迎收藏分享】豆丁网友,9,Personal History,1. Smoking: : Nil 2. Alcohol: Nil 3. Betel nut: Nil 4. Herbal medication: Nil,业精于勤荒于嬉 行成于思毁于随 【医学生物PPT，欢迎收藏分享】豆丁网友,10,Family History,Diabetes Mellitus (-) Hypertension (-) Heart disease (-) Cancer history (-),业精于勤荒于嬉 行成于思毁于随 【医学生物PPT，欢迎收藏分享】豆丁网友,11,Physical Examination,Vital signs: BP: 169/109 mmHg PR: 76/ minutes RR: 19/ minutes BT: 36.5 Consciousness: Clear, GCS: E4M6V5 HEENT: Supple neck, no icteric sclera, no pale conjunctiva Oral: No injection, no bleeder,业精于勤荒于嬉 行成于思毁于随 【医学生物PPT，欢迎收藏分享】豆丁网友,12,Physical Examination,Chest : Symmetric expansion, Normal respiratory pattern Clear breathing sound, no wheezing, no rales Heart : Regular heart beat, no murmur Abdomen : Soft, no distension No tenderness, no palpable mass Normal active bowel sounds,业精于勤荒于嬉 行成于思毁于随 【医学生物PPT，欢迎收藏分享】豆丁网友,13,Laboratory data,业精于勤荒于嬉 行成于思毁于随 【医学生物PPT，欢迎收藏分享】豆丁网友,14,Tentative diagnosis,Hemotysis, r/o acute bronchitis,业精于勤荒于嬉 行成于思毁于随 【医学生物PPT，欢迎收藏分享】豆丁网友,15,Admission course,Admission on 98/02/01 9:31am 98/02/02 11:30 am Consultation of chest 1.Susp. microvascular trauma inducing hemosputum 2.Transamin prescription if bleeding again 3.F/U CXR(PA+lateral) with well-inspiration 4.Sputum AFS, TB culture and cytology X 3 sets 5.Arrange Chest CT and bronchoscopy would be done Arrange CXR & Sputum on 98/02/02 pm,业精于勤荒于嬉 行成于思毁于随 【医学生物PPT，欢迎收藏分享】豆丁网友,16,CXR(02/02),业精于勤荒于嬉 行成于思毁于随 【医学生物PPT，欢迎收藏分享】豆丁网友,17,Admission course,98/02/03 Arrange bronchoscopy Arrange CT,业精于勤荒于嬉 行成于思毁于随 【医学生物PPT，欢迎收藏分享】豆丁网